title: The use of ultrasound in endemic Burkitt lymphoma in Cameroon.
abstract: BACKGROUND
  As ultrasound (US) has become more widely available in sub-Saharan Africa, emerging evidence suggests that the prevalence of abdominal disease in endemic Burkitt lymphoma (eBL) is higher than previous estimates. This retrospective chart review was designed to assess: (1) abdominal US utilisation, (2) the incidence of abdominal disease at diagnosis, (3) correlation of extent of disease at diagnosis with overall and event-free survival (EFS).
  
  
  METHODS
  The charts of 95 consecutive children with eBL diagnosed between April 2006 and 2008 and treated according to the Malawi 2002/03 protocol at the Banso Baptist Hospital in Cameroon were examined for demographics, clinical presentation, diagnostic workup and outcome. Analysis was performed using descriptive statistics, Z-tests and Student's t-tests.
  
  
  RESULTS
  Fifty of 95 presumptive eBL patients (52.7%) had fine needle aspirate (FNA) confirmation of their tumours. Ninety-four of 95 had an US at diagnosis. US was superior to clinical exam in demonstrating abdominal disease (P < 0.001). There was no significant difference between the rates of jaw (73%) and abdominal disease (82%) identified by US at diagnosis. EFS among patients whose disease was upgraded by US (64%) was better that of the patients with clinically diagnosed stage 3 disease.
  
  
  CONCLUSIONS
  We demonstrate that US provides more accurate staging of eBL than clinical examination. Abdominal involvement is more common than previously reported and appears to be as frequent as disease of the jaw at presentation. Further study should determine if more accurate staging with US is useful in risk-stratifying treatment.
authors.affiliation: Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada. stacey.marjerrison@sickkids.ca
authors.forename: S
authors.initials: S
authors.lastname: Marjerrison
authors.forename: C V
authors.initials: CV
authors.lastname: Fernandez
authors.forename: V E
authors.initials: VE
authors.lastname: Price
authors.forename: E
authors.initials: E
authors.lastname: Njume
authors.forename: P
authors.initials: P
authors.lastname: Hesseling
mesh_terms: D002051:Burkitt Lymphoma / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D003906:Developing Countries; D018572:Disease-Free Survival; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014463:Ultrasonography / Q000706:statistics & numerical data